Description
Introduction - Objectives:
The Healthy Life Project in Moldova collaborates with local authorities, primary health care institutions, civil society organizations, and community members to promote integrated, person-centred care, focusing on ensuring vulnerable populations have access to health and social services. Since 24 February 2022, Moldova has received 978’296 refugees from Ukraine, currently hosting 113’132 individuals. We present the project’s dynamic response to the sudden influx, emphasizing the integration of care and participation for refugees within its framework.
Methods:
Employing intersectoral capacity building, community teams have planned and implemented integrated care models, conducting joint assessments and coordinating individual care across various sectors and community resources. Given the urgent situation due to the conflict in Ukraine, the project – within the support provided to people with NCD and complex needs in rural area – adapted the working tools and procedures to address the specific needs of refugees. Continuous support for implementation included considerations for health and social care access along the migratory cycle, particularly for vulnerable groups of women with children, and the elderly. Within the communities, the project followed an inclusive approach in its Health Promotion and Chronic Disease Self-Management Programme (CDSMP), which actively engaged refugees in its activities.
Results and Discussion:
Since the beginning of the conflict in Ukraine, the project provided training on managing NCDs, Social Determinants of Health and Integrated Care within the migration crisis to 366 health and social care managers in all 35 districts. To meet the increased demand for community care, 835 medical kits were distributed to primary health care practitioners, along with protective equipment. A guide for community social workers supporting refugees was developed and embedded in the curricula of the State Pedagogical University. At the community level, refugees from Ukraine actively participated in health promotion activities, including Health Education Seminars, small grant programme and CDSMP. Sessions were tailored to their needs, with materials provided in the requested language, and facilitators guided to treat them with empathy. Information and education sessions on health risk factors and behavioural adjustments had significant success, particularly for elderly people and women with children. Considering the psycho-emotional state of the refugees, sessions on "Stress Management, Depression, and Anxiety," and CDSMP had a positive impact, with each participant receiving materials on managing these states
Although existing differences between the health and social sectors were set aside during activities to support the country in handling the sudden influx of refugees from Ukraine, there remains a need for improved cooperation on all levels.
Conclusions:
The project underscores the importance of a more integrated approach at the community level, coordinated by local authorities and local facilitators, to efficiently utilize scarce resources. Amidst the refugee crisis and compounded challenges, these community-based approaches play a pivotal role in coordinating efforts to support the most vulnerable, including hosted refugees. The findings indicate the potential of such approaches, emphasizing the necessity for ongoing support to build capacity and ensure the implementation of common approaches through a jointly held normative framework.
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